Case Study: Laryngotracheobronchitis

BOOP is a rare lung condition in which the small airways (bronchioles and alveoli) become inflamed with connective tissue. BOOP can be secondary to infections, various drugs, and other medical conditions. In many cases, the underlying cause of BOOP is unknown. Anticonvulsant medications are widely used in pediatrics for different seizure disorders. ACHS is characterized by fever, rash and internal organ involvement. It is a rare, but

Croup has been defined by NICE (2012) as being a common childhood illness that is usually

Main Question Post: Week 5 Discussion -- Review of Case Study #2: Focused Throat Exam

One of the most common laryngeal pathological changes is called vocal fold nodules (Phillippe H. al., et 2009). While looking at vocal fold nodules, one may notice tiny bilateral lesions. The SLP may also discover that vocal fold nodules appear as proportional mass lesions. The history of vocal fold nodules dates back to 1866, when the pathology was first discovered by Turk (Simpson B al., et 2008). “Vocal fold nodules occur more frequently in children and women (Simpson B al., et 2008).” “Another interesting fact is that 95% of the vocal fold nodule cases among adults are female and 5% male (Phillipe 2009).” Vocal fold nodules cause an hourglass closure glottal configuration secondary to the nodules developing at the junction of the

Epiglottitis is an inflammation of the epiglottis. The epiglottis is a flat cartilage that extends from the base of the tongue back-ward and upward. This is the tissue that covers the trachea or wind-pipe. It helps prevent food or any artifact that may enter. The tissue of the epiglottis can swell and block the airway. If suspected, seek medical attention immediately. This mainly affects children by the bacteria called Haemophilus influenzae type b. It is the most responsible for this type of inflammation.

The patient manifested signs of respiratory distress precipitated by a pneumonia and bronchiolitis infection. A.D was on 0.5 liters of oxygen via nasal prongs with an oxygen saturation reading of 94%. On prior days without the supplemental oxygen, she was desaturating to below 92%, “ high flow rates generate continuous positive pressure in the airways that could help reduce the work of breathing in bronchiolitis and decrease the need for more invasive respiratory support” (Casey, 2015, p. 24). The patient had a respiratory rate of 42 breaths per minute and the normal respiratory rate for a 13month old as stated in Perry et al. (2013) ranges between 20-40 breaths per minute. Also, the patient had a heart rate of 158 beats per minute and the

Currently, standards for the diagnosis and treatment of AB are inconsistent, but all guidelines recommend avoiding prescribing antibiotics for acute cough/AB (Dempsey, Businger, Whaley, Gagne & Linder, 2014). A viral infection is usually a self-limited illness (Busse & Lemanske, 2010). Symptoms management such as cough control is the goal and recommended in managing AB. Therefore, the importance of the familiarity of the clinicians with the recent clinical guidelines for AB and adherence to the guidelines is recommended, but can be challenging in terms of consistently utilizing the guidelines into their practice (McCollough, Zimmerman, and Rodriguez, 2014).

Dyspnea was the commonest symptoms seen in all patients followed by cough and fever. Half of the patients had crackles on examination, and half were hypoxic at rest. Chest x ray showed some abnormality in 80% of cases. CT of chest is more sensitive and showed ground glass densities in 65% of cases followed by nodules in 53%. Pulmonary functions tests revealed obstruction in one third of cases. Most cases were diagnosed based on sputum examination. Transbronchial biopsy was able to establish diagnosis 75% of cases. Biopsy showed granuloma in 92% of cases. One third of patients received Antimycobacterial drugs alone and 16% of patients received steroids alone. The specific dose and duration of steroids is not reported accurately in literature and hence the optimal regime of steroid therapy is not known. If antimycobacteral treatment is considered, then American Thoracic Society(ATS) recommends treatment with three drug Azithromycin/Clarithromycin, Ethambutol and Rifampin for 12 to 18 months. While 23% of patients received both treatment, 20% of patients were not given any specific treatment except abstinence from source. Despite of the type of treatment regime used, clinical response was seen in all patients and 60% patients showed complete resolution. No death due to HTL has been reported till date.

Tracheobronchomalacia is the collapse of the trachea and one or both of the bronchi. This occurs do to the softening of the cartilaginous rings. The collapse can be classified in many ways but the shape of the airway after they are affected can be classified as crescent, which is when one side of the bronchial tube is caved in which causes it to have a crescent shape, or concentric which is when all sides of the tubes collapse and it creates a circular hole in the middle in which air can pass through. When we are born, the cartilaginous rings that support our trachea and bronchial tubes are made up of hyaline cartilage. Over time these rings are supposed to go through the process of ossification and harden. When the cartilage does not harden and there is something that causes the rings to collapse onto the airway, it is classified as congenital or primary

Medical treatments may also be required to alleviate the difficulty in breathing. Anti-inflammatory medicines, such as corticosteroids and bronchodilators are traditionally used orally or injected. Recently aerosolized medicines have been prescribed after the development of the Aeromask (a tight fitting mask placed over the horse’s nose that works much like an inhaler in humans). While the aerosolized treatments are somewhat cost prohibitive, they are very effective and have less risk of adverse side

TJ is a 25-year-old Hispanic female, born on September 21st 1991 in Queens, New York. Participant would be at risk for hypertension, diabetes, and heart failure based on familial history. Obesity would be one of the precursor that puts TJ at a higher risk for developing diabetes. Obesity comorbid with Asthma later in life puts TJ at higher risk for having respiratory failure. Hidradenitis Suppurativa (HS) is a debilitating autoimmune disorder. The lesions can cause agonizing pain, and discomfort that can interfere with activities of daily living. This can also impact activities that can help alleviate the symptoms such as exercise. The fact that TJ is obese, only exacerbates the symptoms of the condition. Since HS is an autoimmune disease,

Mr. Franklin is a 38 yo male with a history of reactive airway disease who presents today complaining of RLQ stomach pain that started yesterday on his way home from work and progressively got worse overnight. He describes his pain as sharp when moving, dull and crampy when not moving. It does not radiate. Early this morning he had an episode of nausea and vomiting that temporarily subdued his pain. He took Aspirin about 4-5 hours ago for the pain though it didn’t help. He hasn’t had a BM in 3 days but it is not abnormal for him. He denies diarrhea or constipation. His vitals are normal with a slightly elevated temp. of 99.4. Mr. Franklin is coughing a lot today. He said that he is always coughing a little and that he is always congested. He

Vicky has returned for review six weeks since the last appointment. Overall she has been quite well during that time, but having paid closer attention, is reporting intermittent episodes of laryngospasm/vocal cord dysfunction. Specifically after extended periods of talking, Vicky is noticing some tightness in her larynx and at times dysphonia. She may also become slightly breathless, but with slow breathing and resting her voice, her symptoms settle within a few minutes. Separate to this, she has also noted intermittent retrosternal tightness and mild dyspnoea that is consistently relieved with belching. She is no reporting any exertional symptoms.

Peter was born after an uneventful pregnancy and weighed 3.1kg. At 3 months, he developed otitis media and an upper respiratory tract infection. At the ages of 5 months and 11 months, he was admitted to hospital with Haemophilus influenzae pneumonia. The infections responded promptly to the appropriate antibiotics on each occasion. He is the fourth child of unrelated parents: his three sisters show no predisposition to infection.

History of Present Illness: Ms. Leach is a very pleasant 85-year-old woman who was last seen by William Pease, DO for a history of bronchiectasis. Her bronchiectasis is very mild and predominantly basilar. She has had prior lobectomy secondary to multiple recurrent pneumonias and [_:30___] bronchiectasis. She has required no hospitalizations. Her symptoms are stable. She has a very minimal cough without sputum production. She does have some shortness of breath with exertion. Her dyspnea is complicated by chronic congestive heart failure.